3.4 Autoimmune Diseases Flashcards
What is a general definition for autoimmunity?
A. Increase of tolerance to self-antigens
B. Loss of tolerance to self-antigens
C. Increase in clonal deletion of mutant cells
D. Manifestation of immunosuppression
B. Loss of tolerance to self-antigens
An ANA test is performed on a specimen from a 55-year-old woman who has unexplained joint pain. The IFA result shows a titer of 40 and a homogeneous pattern. The appropriate follow-up for this patient is:
A. Anti-DNA assay
B. Extractable nuclear antigen (ENA) testing
C. Retest ANA in 3 to 6 months
D. CH50 complement assay
C. Retest ANA in 3 to 6 months
Which disease is likely to show a rim (peripheral) pattern in an immunofluorescence (IF) microscopy test for ANA?
A. Mixed connective tissue disease (MCTD)
B. RA
C. SLE
D. Scleroderma
C. SLE
A patient’s specimen is strongly positive in an ANA ELISA. Which of the following would NOT be an appropriate follow-up to this result?
A. IFA on human epithelial type 2 (HEp-2) cells
B. Specific ENA ELISA tests
C. Specific anti-DNA ELISA
D. Rheumatoid factor (RF) assay
D. Rheumatoid factor (RF) assay
What type of antibodies is represented by the homogeneous pattern in the IFA for ANAs?
A. Antihistone antibodies
B. Anticentromere antibodies
C. Anti-ENA (anti-Smith [anti-Sm] and anti-ribonucleoprotein [anti-RNP]) antibodies
D. Anti-RNA antibodies
A. Antihistone antibodies
What disease is indicated by a high titer of anti-Sm antibody?
A. MCTD
B. RA
C. SLE
D. Scleroderma
C. SLE
Which disease is least likely when a nucleolar pattern occurs in an IFA for ANAs?
A. MCTD
B. Sjögren syndrome
C. SLE
D. Scleroderma
A. MCTD
All of the diseases except MCTD may cause a nucleolar pattern of immunofluorescence. Nucleolar fluorescence is caused by anti-RNA antibodies and is seen in about 50% of patients with scleroderma.
What antibodies are represented by the nucleolar pattern in the IFA for ANAs?
A. Antihistone antibodies
B. Anti-dsDNA antibodies
C. Anti-ENA (anti-Sm and anti-RNP) antibodies
D. Anti-RNA antibodies
D. Anti-RNA antibodies
Which test would best distinguish between SLE and MCTD?
A. Multiplex or ELISA test for anti-Sm and anti-RNP
B. IFA using Crithidia as substrate
C. Slide agglutination testing
D. Laboratory tests cannot distinguish between these disorders
A. Multiplex or ELISA test for anti-Sm and anti-RNP
An ANA test on HEp-2 cells shows nucleolar staining in interphase cells and dense chromatin staining in mitotic cells. The most likely cause of this staining pattern is:
A. Antifibrillarin antibody
B. Anti–ribosomal P antibody
C. A serum with nucleolar and homogeneous patterns
D. Technical artifact
A. Antifibrillarin antibody
Which immunofluorescence pattern indicates the need for ENA testing by multiplex, line blots, or ELISA assays?
A. Homogeneous or solid
B. Peripheral or rim
C. Speckled
D. Nucleolar
C. Speckled
Which of the following is used in rapid slide tests for detection of RFs?
A. Whole IgM molecules
B. Fc portion of the IgG molecule
C. Fab portion of the IgG molecule
D. Fc portion of the IgM molecule
B. Fc portion of the IgG molecule
Which of the following methods is least likely to give a definitive result for the diagnosis of RA?
A. Nephelometric measurement of anti-IgG
B. Agglutination testing for RF
C. Anti-CCP
D. IFA for ANAs
D. IFA for ANAs
Which disease might be indicated by antibodies to smooth muscle?
A. Atrophic gastritis
B. Autoimmune hepatitis
C. Myasthenia gravis
D. Sjögren syndrome
B. Autoimmune hepatitis
Antibodies to thyroid peroxidase may appear in which of the following diseases?
A. Graves disease and Hashimoto thyroiditis
B. Myasthenia gravis
C. Granulomatous thyroid disease
D. Addison disease
A. Graves disease and Hashimoto thyroiditis
